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A hierarchical analysis of long-term illness and mortality in socially deprived areas

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  • Malmström, Marianne
  • Johansson, SvenErik
  • Sundquist, Jan

Abstract

This article is a multilevel analysis of the effects on self-reported long-term illness and mortality of the socio-economic position of the neighbourhood. Using data from the Swedish Level of Living Survey, neighbourhood social position is measured by a composite Care Need Index, (CNI) together with such indicators of individual socio-economic position as occupation and housing tenure, with adjustment for age, sex, marital status and social network. Data came from 22,236 people aged 25-74, and were collected from 1988 to 1992. The cross-sectional data were analysed using a hierarchical logistic regression model. In a second analysis, each participant was followed from the initial interview until his or her death, or until the termination of data collection (31 December 1996). A neighbourhood's low social position and an individual resident's low socio-economic position (i.e., a manual worker, or person renting a flat) were found to be associated with increased risk of long-term illness. We conclude that a neighbourhood's low socio-economic position, that is, a high score on the CNI, is a risk factor for long-standing illness above and beyond an individual's socio-economic position. The differences in mortality could be explained by the included independent individual variables.

Suggested Citation

  • Malmström, Marianne & Johansson, SvenErik & Sundquist, Jan, 2001. "A hierarchical analysis of long-term illness and mortality in socially deprived areas," Social Science & Medicine, Elsevier, vol. 53(3), pages 265-275, August.
    • Handle: RePEc:eee:socmed:v:53:y:2001:i:3:p:265-275
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    Cited by:

    1. L. Weinstein, Bernard, 2006. "The Role of Group Purchasing Organizations (GPOs) in the U.S. Medical Industry Supply Chain/El Papel De Las Organizaciones De Grupos De Compra (Gpos) En La Cadena De Suministros Médicos En Estados Uni," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 24, pages 789-802, Diciembre.
    2. Jens Klein & Nico Vonneilich & Sebastian Baumeister & Thomas Kohlmann & Olaf Knesebeck, 2012. "Do social relations explain health inequalities? Evidence from a longitudinal survey in a changing eastern German region," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(3), pages 619-627, June.
    3. van Hooijdonk, Carolien & Droomers, Mariël & van Loon, Jeanne A.M. & van der Lucht, Fons & Kunst, Anton E., 2007. "Exceptions to the rule: Healthy deprived areas and unhealthy wealthy areas," Social Science & Medicine, Elsevier, vol. 64(6), pages 1326-1342, March.
    4. Oliveira, Monica D. & Bevan, Gwyn, 2008. "Modelling hospital costs to produce evidence for policies that promote equity and efficiency," European Journal of Operational Research, Elsevier, vol. 185(3), pages 933-947, March.
    5. David M. Wright & Michael Rosato & Dermot O’Reilly, 2017. "Which long-term illnesses do patients find most limiting? A census-based cross-sectional study of 340,000 people," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(8), pages 939-947, November.
    6. Wen, Ming & Hawkley, Louise C. & Cacioppo, John T., 2006. "Objective and perceived neighborhood environment, individual SES and psychosocial factors, and self-rated health: An analysis of older adults in Cook County, Illinois," Social Science & Medicine, Elsevier, vol. 63(10), pages 2575-2590, November.
    7. Adrienne La Grange, 2011. "Neighbourhood and Class," Urban Studies, Urban Studies Journal Limited, vol. 48(6), pages 1181-1200, May.
    8. Jaffe, Dena H. & Eisenbach, Zvi & Neumark, Yehuda D. & Manor, Orly, 2005. "Individual, household and neighborhood socioeconomic status and mortality: a study of absolute and relative deprivation," Social Science & Medicine, Elsevier, vol. 60(5), pages 989-997, March.
    9. Lengen, Charis & Blasius, Jörg, 2007. "Constructing a Swiss health space model of self-perceived health," Social Science & Medicine, Elsevier, vol. 65(1), pages 80-94, July.
    10. Pampalon, Robert & Hamel, Denis & De Koninck, Maria & Disant, Marie-Jeanne, 2007. "Perception of place and health: Differences between neighbourhoods in the Québec City region," Social Science & Medicine, Elsevier, vol. 65(1), pages 95-111, July.
    11. Kyoung-Hee Cho & Juyeong Kim & Young Choi & Tae-Hyun Kim, 2022. "The Effect of Neighborhood Deprivation on Mortality in Newly Diagnosed Diabetes Patients: A Countrywide Population-Based Korean Retrospective Cohort Study, 2002–2013," IJERPH, MDPI, vol. 19(7), pages 1-14, April.
    12. Meijer, Mathias & Röhl, Jeannette & Bloomfield, Kim & Grittner, Ulrike, 2012. "Do neighborhoods affect individual mortality? A systematic review and meta-analysis of multilevel studies," Social Science & Medicine, Elsevier, vol. 74(8), pages 1204-1212.

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